Eur J Cardiothorac Surg 2008;34:667. doi:10.1016/j.ejcts.2008.05.055
Copyright © 2008, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
Images in cardio-thoracic surgery |
Extensive left anterior descending endarterectomy and multiple drug-eluting stent removal in a patient with in-stent occlusion
Javier G. Castillo,
Indran Ramanathan,
Farzan Filsoufi*
Department of Cardiothoracic Surgery, Mount Sinai School of Medicine, 1190 Fifth Avenue, New York, NY 10029, USA
Received 17 April 2008;
received in revised form 22 May 2008;
accepted 29 May 2008.
* Corresponding author. Tel.: +1 212 659 6820; fax: +1 212 659 6818. (Email: farzan.filsoufi{at}mountsinai.org).
Key Words: Percutaneous coronary intervention • Stentectomy • Coronary artery bypass grafting
A 58-year-old woman underwent multiple drug-eluting stent implantations in the left anterior descending (LAD) artery. She developed recurrent ischemia due to in-stent occlusion (Fig. 1A and B). An extensive LAD endarterectomy with stent removal was performed successfully (Fig. 1C and D) followed by a saphenous patch reconstruction and mammary artery anastomosis (Fig. 1E).
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Fig. 1. (A and B) Preoperative angiography revealed mid-to-distal stent occlusion of the LAD, (C) intra-operative view, (D) endarterectomy material and (E) extensive LAD reconstruction with saphenous patch and left internal mammary artery to patch anastomosis. At 4 months, the patient is doing well without symptoms. She had a stress test, which was negative.
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